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2006-03-24 21:25:26 UTC
Sleep Deprivation: The Great American Myth
Robin Lloyd
Special to LiveScience
LiveScience.comThu Mar 23, 12:00 PM ET
People who get only 6 to 7 hours a night have a lower death rate than those
who get 8 hours of sleep. -From a six-year study of more than a million
adults
Many Americans are sleep-deprived zombies, and a quarter of us now use some
form of sleeping pill or aid at night.
Wake up, says psychiatry professor Daniel Kripke of the University of
California, San Diego. The pill-taking is real but the refrain that
Americans are sleep deprived originates largely from people funded by the
drug industry or with financial interests in sleep research clinics.
"They think that scaring people about sleep increases their income," Kripke
told LiveScience.
Thanks to the marketing of less addictive drugs directly to consumers,
sleeping pills have become a hot commodity, especially in the past five
years. People worldwide spent $2 billion on the most popular sleeping pill,
Ambien (zolpidem), in 2004, according to the BioMarket, a biotech research
company.
Earlier this month, it was reported that some Ambien users are susceptible
to amnesia and walking in their sleep. Some even ate in the middle of the
night without realizing it.
Global sales for all sleeping pills, called hypnotics, will top $5 billion
in the next several years.
The number of adults aged 20-44 using sleeping pills doubled from 2000 to
2004, according to Medco Health Solutions, a managed care company. Sleep
problems are commonly reported in the elderly, but the increase in spending
on sleeping pills was highest in this period for 10-19 year olds, possibly
due to an association with medication for attention deficit hyperactivity
disorder (ADHD).
Sleep on this
Still, more sleep is no guarantee for overall health, and more sleeping
pills might not bring on either.
A six-year study Kripke headed up of more than a million adults ages 30 to
102 showed that people who get only 6 to 7 hours a night have a lower death
rate than those who get 8 hours of sleep. The risk from taking sleeping
pills 30 times or more a month was not much less than the risk of smoking a
pack of cigarettes a day, he says.
Those who took sleeping pills nightly had a greater risk of death than those
who took them occasionally, but the latter risk was still 10 to 15 percent
higher than it was among people who never took sleeping pills. Sleeping
pills appear unsafe in any amount, Kripke writes in his online book, "The
Dark Side of Sleeping Pills."
"There is really no evidence that the average 8-hour sleeper functions
better than the average 6- or 7-hour sleeper," Kripke says, on the basis of
his ongoing psychiatric practice with patients along with research,
including the large study of a million adults (called the Cancer Prevention
Study II).
And he suspects that people who sleep less than average make more money and
are more successful.
The Cancer Prevention Study II even showed that people with serious insomnia
or who only get 3.5 hours of sleep per night, live longer than people who
get more than 7.5 hours.
And there are questions about the effectiveness of sleeping pills. A study
by researchers at Beth Israel Deaconess Medical Center and Harvard Medical
School found that a change in sleep habits and attitudes was more effective
in treating chronic insomnia, over the short- and long-term, than sleeping
pills (specifically Ambien).
Night of the living dead
Until 15 years ago, sleeping pills were mainly addictive barbiturates (such
as Seconal, Halcion, Qualude) and sedatives called benzodiazepines (Valium
and Dalmane). For this reason, they were less popular and less prescribed.
That changed in the early 1990s when Ambien, which is less addictive, came
on the market. It acts on the same neural receptors as a benzodiazepine, but
is safer. It is the only hypnotic drug Kripke recommends and then, only for
fewer than four weeks. Other new hypnotic drugs are safe but ineffective, he
says.
Most sleeping pills are recommended for short-term use, but lots of people
take them frequently and become dependent upon them to fall asleep. Most
sleeping pills, especially when taken over long periods of time, stay in the
bloodstream, giving a hangover the next day and beyond, impairing memory and
performance on the job and at home.
A time-release version of Ambien (Ambien CR) bound for the market and
designed to prevent waking after 4 hours when the drug normally would wear
off, along with one of the newest pills on the market, Lunesta, or
eszopiclone, (designed for longer-term use) might be even more harmful in
this way, Kripke says.
Hypnotic drugs have dangerous side effects, Kripke says. For one, they
reduce fear of risky behavior, such as driving fast. Ironically, that could
result in the inability to see that the sleeping pills are doing more harm
than good over time.
A recent study published in the British Medical Journal showed that the
risks of taking sleeping pills (benzodiazepines and other sedatives, in this
case) outweighed the benefits among people over 60 in a series of studies
carried out between 1966 and 2003. The pills helped people fall asleep and
they slept more, but they were twice as likely to slip and fall or crash a
car due to dizziness from the pills than they were to get a better night's
sleep.
Even the safest hypnotic drugs have strange side effects, as the alleged
Ambien sleepwalkers showed.
And one over-the-counter approach, the hormone melatonin, was found by
scientists at the University of Alberta, Canada, to be ineffective in
treating jet lag and sleep trouble associated with medical problems. Studies
also show it is associated with skin blanching in frogs, gonadal atrophy in
small animals, and obesity in some mammals.
Are you sleeping?
The real number of Americans with sleep problems is unclear because the same
figure-70 million-appears on National Institutes of Health documents from
2006 and from 1994. This catch-all category reportedly includes insomnia,
jetlag, sleepwalking, bed wetting, night terrors, restless legs syndrome,
narcolepsy and disordered breathing during sleep (called apnea).
The National Sleep Foundation, the source of many sleep surveys and
statistics, has financial and institutional ties to sleeping pill
manufacturers, according to the Sacramento Bee newspaper.
Sleep problems could be increasing, Kripke says, but there is no evidence
for this. If they are increasing, it could be a result of less exposure to
daylight (due to cable TV, the Internet, indoor gyms) and increasing
obesity, which causes apnea. But he still recommends against taking sleeping
pills in nearly all cases and in favor of improved sleep habits.
"Sleeping pills usually do more harm than good," he says.
Robin Lloyd
Special to LiveScience
LiveScience.comThu Mar 23, 12:00 PM ET
People who get only 6 to 7 hours a night have a lower death rate than those
who get 8 hours of sleep. -From a six-year study of more than a million
adults
Many Americans are sleep-deprived zombies, and a quarter of us now use some
form of sleeping pill or aid at night.
Wake up, says psychiatry professor Daniel Kripke of the University of
California, San Diego. The pill-taking is real but the refrain that
Americans are sleep deprived originates largely from people funded by the
drug industry or with financial interests in sleep research clinics.
"They think that scaring people about sleep increases their income," Kripke
told LiveScience.
Thanks to the marketing of less addictive drugs directly to consumers,
sleeping pills have become a hot commodity, especially in the past five
years. People worldwide spent $2 billion on the most popular sleeping pill,
Ambien (zolpidem), in 2004, according to the BioMarket, a biotech research
company.
Earlier this month, it was reported that some Ambien users are susceptible
to amnesia and walking in their sleep. Some even ate in the middle of the
night without realizing it.
Global sales for all sleeping pills, called hypnotics, will top $5 billion
in the next several years.
The number of adults aged 20-44 using sleeping pills doubled from 2000 to
2004, according to Medco Health Solutions, a managed care company. Sleep
problems are commonly reported in the elderly, but the increase in spending
on sleeping pills was highest in this period for 10-19 year olds, possibly
due to an association with medication for attention deficit hyperactivity
disorder (ADHD).
Sleep on this
Still, more sleep is no guarantee for overall health, and more sleeping
pills might not bring on either.
A six-year study Kripke headed up of more than a million adults ages 30 to
102 showed that people who get only 6 to 7 hours a night have a lower death
rate than those who get 8 hours of sleep. The risk from taking sleeping
pills 30 times or more a month was not much less than the risk of smoking a
pack of cigarettes a day, he says.
Those who took sleeping pills nightly had a greater risk of death than those
who took them occasionally, but the latter risk was still 10 to 15 percent
higher than it was among people who never took sleeping pills. Sleeping
pills appear unsafe in any amount, Kripke writes in his online book, "The
Dark Side of Sleeping Pills."
"There is really no evidence that the average 8-hour sleeper functions
better than the average 6- or 7-hour sleeper," Kripke says, on the basis of
his ongoing psychiatric practice with patients along with research,
including the large study of a million adults (called the Cancer Prevention
Study II).
And he suspects that people who sleep less than average make more money and
are more successful.
The Cancer Prevention Study II even showed that people with serious insomnia
or who only get 3.5 hours of sleep per night, live longer than people who
get more than 7.5 hours.
And there are questions about the effectiveness of sleeping pills. A study
by researchers at Beth Israel Deaconess Medical Center and Harvard Medical
School found that a change in sleep habits and attitudes was more effective
in treating chronic insomnia, over the short- and long-term, than sleeping
pills (specifically Ambien).
Night of the living dead
Until 15 years ago, sleeping pills were mainly addictive barbiturates (such
as Seconal, Halcion, Qualude) and sedatives called benzodiazepines (Valium
and Dalmane). For this reason, they were less popular and less prescribed.
That changed in the early 1990s when Ambien, which is less addictive, came
on the market. It acts on the same neural receptors as a benzodiazepine, but
is safer. It is the only hypnotic drug Kripke recommends and then, only for
fewer than four weeks. Other new hypnotic drugs are safe but ineffective, he
says.
Most sleeping pills are recommended for short-term use, but lots of people
take them frequently and become dependent upon them to fall asleep. Most
sleeping pills, especially when taken over long periods of time, stay in the
bloodstream, giving a hangover the next day and beyond, impairing memory and
performance on the job and at home.
A time-release version of Ambien (Ambien CR) bound for the market and
designed to prevent waking after 4 hours when the drug normally would wear
off, along with one of the newest pills on the market, Lunesta, or
eszopiclone, (designed for longer-term use) might be even more harmful in
this way, Kripke says.
Hypnotic drugs have dangerous side effects, Kripke says. For one, they
reduce fear of risky behavior, such as driving fast. Ironically, that could
result in the inability to see that the sleeping pills are doing more harm
than good over time.
A recent study published in the British Medical Journal showed that the
risks of taking sleeping pills (benzodiazepines and other sedatives, in this
case) outweighed the benefits among people over 60 in a series of studies
carried out between 1966 and 2003. The pills helped people fall asleep and
they slept more, but they were twice as likely to slip and fall or crash a
car due to dizziness from the pills than they were to get a better night's
sleep.
Even the safest hypnotic drugs have strange side effects, as the alleged
Ambien sleepwalkers showed.
And one over-the-counter approach, the hormone melatonin, was found by
scientists at the University of Alberta, Canada, to be ineffective in
treating jet lag and sleep trouble associated with medical problems. Studies
also show it is associated with skin blanching in frogs, gonadal atrophy in
small animals, and obesity in some mammals.
Are you sleeping?
The real number of Americans with sleep problems is unclear because the same
figure-70 million-appears on National Institutes of Health documents from
2006 and from 1994. This catch-all category reportedly includes insomnia,
jetlag, sleepwalking, bed wetting, night terrors, restless legs syndrome,
narcolepsy and disordered breathing during sleep (called apnea).
The National Sleep Foundation, the source of many sleep surveys and
statistics, has financial and institutional ties to sleeping pill
manufacturers, according to the Sacramento Bee newspaper.
Sleep problems could be increasing, Kripke says, but there is no evidence
for this. If they are increasing, it could be a result of less exposure to
daylight (due to cable TV, the Internet, indoor gyms) and increasing
obesity, which causes apnea. But he still recommends against taking sleeping
pills in nearly all cases and in favor of improved sleep habits.
"Sleeping pills usually do more harm than good," he says.
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